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Open Access Research article

Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands

Jan EAM van Bergen1*, Johannes SA Fennema2, Ingrid VF van den Broek5, Elfi EHG Brouwers4, Eva M de Feijter1, Christian JPA Hoebe4, Rik H Koekenbier2, Eline LM Op de Coul5, Sander M van Ravesteijn3 and Hannelore M Götz3

Author Affiliations

1 STI AIDS Netherlands, Amsterdam, The Netherlands

2 Amsterdam Public Health Service, Amsterdam, The Netherlands

3 Rotterdam Rijnmond Public Health Service, Rotterdam, The Netherlands

4 Department of Infectious Diseases, South Limburg Public Health Service, Geleen, The Netherlands

5 Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

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BMC Infectious Diseases 2010, 10:293  doi:10.1186/1471-2334-10-293

Published: 7 October 2010

Abstract

Background

Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme.

Methods

A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl webcite with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value.

Results

We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%.

Conclusions

This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.